"Always do right. This will gratify some people, and astonish the rest." Mark Twain

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Mission Statement (and disclaimer)

* To inform, educate, inspire colleagues and general public by sharing my own experiences, observations, thoughts, and insights drawn from my life and career in medicine and surgery.

* To explore my life and surgical career, as my journey progresses.

* To pose questions, address controversies, frame debate and discussion about/around topics, events, and issues that touch medicine and surgery, and the physicians and surgeons, institutions, and people involved and affected.

This will mainly be framed in the context of personal essays, discussions, conversations, observations (albeit one-sided).

I speak only for myself, the thoughts and opinions are mine; if I quote or borrow from others, appropriate attribution will be made.The educational and other institutions, groups, and organizations I have been and continue to be involved with have not sanctioned or approved the content, my comments here should not and do not reflect their opinions or represent them in any way. Likewise, I do not deign to represent my peers and colleagues. With that said, I hope that I respect and honor them all here in this place.

Posts and the information shared should not be taken as medical or treatment advice; any concerns or problems should be discussed and evaluated with your own physician or health care provider.

Comments are welcome, but will be reviewed and approved before posting.

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What’s in a Name

A rose, by any other name, would smell as sweet.Wm. Shakespeare, Romeo and JulietteA rose is a rose is a rose. Gertrude Stein

“This is Dr. Hughes” or “Hello, I’m Dr. Kathy Hughes” — This is how I answer the phone, or introduce myself as I walk in to a room.

I think it matters what I am called, how I am addressed. It also matters what I call you, as my patient, and how I address you.

Any Tom, Dick, or Kathy can be Tom, or Dick, or Kathy. But it conveys a special role and relationship to use one’s title or formal name. Not everyone can be Doctor to you, and especially not Your Doctor. It is a special and particular relationship that I have with you. I’m your Doctor, I’m your Surgeon, I’m Dr. Hughes.

And in addressing my patients as Mr., Mrs., Ms., or Dr. (perhaps only with the exception of the very young and the very old, where stage of development or dementia interfere) I also convey and acknowledge the special relationship they have with me.

I admit, I still call my parents Mom and Dad; my aunts and uncles have likewise retained those titles. And even to their chagrin, I use the formal titles to address my parents’ friends, and my old teachers and professors. It’s not just a reflection of how I was raised, but an acknowledgment of the special bonds and relationships in this part of my life, too.

It is important to acknowledge these relationships and bonds. How you address someone, what you call them, does that. It is like a shorthand, a shortcut, spelling it out. It honors them–the relationship, the bond, the person.

I remember a lot of eye-rolling and joking at the expense of the early feminists in the Sixties and Seventies, when they objected to what they felt were sexist titles and names. So work titles like “Mailman” evolved to “Mailperson” to “Letter Carrier”; first year college classes changed from “Freshmen” to “Freshpersons or Freshwomen” to “Firsties” (at least at some Womens’ Colleges). But as silly as some of this seemed and seems, the feminists had it right–there is power and identity in what you call something or someone, or how you refer to them; power in naming. Likewise, the kind of naming, or failure to name, can do the opposite, diminishing power and instead offering disrespect, even contempt.

I confess that I bristle when I am called by my first name by a patient or their family member if I have not invited them to do so. Because in those situations, where I am respecting them by using their formal name, I feel that they are being casual and dismissive, even disrespectful, in return. It is a power play, always by a patient or family member who wants to be sure that I know exactly who is in control, and that it is not me. They may not mean it as overt disrespect, but on some level it is a challenge to my role, my authority, meant to “take me down a peg”.

I choose to honor and empower my patients, respecting the bond we share in the Physician-Patient, Surgeon-Patient relationship. I honor the responsibility and trust that they place quite literally in my hands; sharing freely the most intimate and personal details of their health and lives, details that often are not even known by their own partners and families, and even some that they have not admitted to themselves. I will be caring for them, in the most personal way possible, by operating on them, peering inside of their bodies, where no one else goes. This is an overwhelming and awesome responsibility, empowered by the mutual trust and respect between me and my patient. This trust and respect help me as I strive to do the best I can for them.

Times change, the world gets smaller and more familiar, and we are all more casual in our interactions. I do not think of my practice here to be an anachronism, though. Words are powerful. Communication is important. Bolstering good communication and a good relationship with my patient improves my ability to care for them. I choose to use my words, their names, to respect my patients, in so doing also respecting that sacred trust between us, as I carry on in my most unique and special role for them as their physician and surgeon.